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- ItemAcesso aberto (Open Access)Continuing education on child development for primary healthcare professionals: a prospective before-and-after study(Associação Paulista de Medicina - APM, 2014-07-01) Figueiras, Amira Consuêlo Melo; Puccini, Rosana Fiorini [UNIFESP]; Silva, Edina Mariko Koga da [UNIFESP]; Universidade Federal do Pará School of Medicine; Universidade Federal de São Paulo (UNIFESP)CONTEXT AND OBJECTIVE:Children's developmental disorders are often identified late by healthcare professionals working in primary care. The aim of this study was to assess the impact of a continuing education program on child development, on the knowledge and practices of these professionals.DESIGN AND SETTING:Prospective single-cohort study (before-and-after study), conducted in the city of Belém, Pará , Brazil.METHODS:Two hundred and twenty-one professionals working in primary healthcare (82.2%) participated in a continuing education program on child development and were assessed before and after implementation of the program through tests on their knowledge of child development, consisting of 19 questions for physicians and 14 for nurses, and questionnaires on their professional practices.RESULTS:One to three years after the program, the mean number of correct answers in the tests had increased from 11.5 to 14.3 among physicians in the Healthy Family Program (Programa Família Saudável, PFS); 13.0 to 14.3 among physicians in Municipal Health Units (Unidades Municipais de Saúde, UMS); 8.3 to 10.0 among PFS nurses; and 7.8 to 9.4 among UMS nurses. In interviews with mothers attended by these professionals before the program, only 21.7% reported that they were asked about their children's development, 24.7% reported that the professional asked about or observed their children's development and 11.1% received advice on how to stimulate them. After the program, these percentages increased to 34.5%, 54.2% and 30.3%, respectively.CONCLUSIONS:Professionals who participated in the program showed improved performance regarding child development knowledge and practices.
- ItemAcesso aberto (Open Access)Desenvolvimento, aplicação e avaliação de um programa nacional de educação a distância para profissionais da área da saúde sobre resistência microbiana e uso racional de antimicrobianos(Universidade Federal de São Paulo (UNIFESP), 2010-08-25) Guerra, Carla Morales [UNIFESP]; Medeiros, Eduardo Alexandrino Servolo de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Education and updating of health professionals should be considered as an integral part of strategies to resistance control and to maintain quality of care and patient safety. Objective: To develop and apply a Web-based program on infection control practices and antimicrobial resistance for healthcare workers involved with healthcare-acquired infection from different demographic Brazilian regions, and to assess the knowledge and perceptions of participants. To evaluate the perception and attitude of professionals working in committees hospital infection control registered for the course of the infection control program in their institutions. Method: The study was conducted at the Division of Infectious Diseases and Department of Informatics and Health of Federal University of São Paulo. Were developed and implemented two courses: RMcontrole, directed to health professionals in general and ATMracional, directed only antimicrobial prescribers (physicians and dentists). Professionals should register on line in the site of the course. The selection of students prioritized professionals from the Midwest and North of the country involved in the area of hospital infection control. The course was offered free to the professionals. The program involved production of a printed booklet and a CD-ROM sent to the address of work, beyond the creation of website. One of the features of this work was the use of e-learning platform Moodle. The activities of each student tutors were monitored by specialists in hospital infection control and to pass the course was required score of 70% in the proposed activities and assessments. Results: The total number of professionals registered for the course RMcontrole was 6256 and the course was ATMracional 2856, among whom were selected in 1172 and 917 professionals for each course respectively. The dropout rate in the course RMcontrole was 9.1% and ATMracional was 8.0%, the approval rate was 96.4% and 93.5% and disapproval rate was 3.6% and 6.5 %, respectively. For most participants this was the first participation in a distance course even so, few students reported difficulties with the study via the Internet. The study tool preferred by most professional was the book printed, but approximately 20.0% of professionals reported prefer to study via the Internet. The assessment of participants on the course content showed that in relation to the scope and update more than 95.5% were satisfied or extremely satisfied. The discussions between tutors and participants surpassed the mark of 1,000 posts in each course. Analysis of the scores in both courses showed that there was difference between the initial and final notes, allowing us to conclude that there was knowledge acquisition (p <0.001). Conclusion: This was the first free national program for training health professionals on microbial resistance. We believe that the improvement of this methodology will allow access to technical knowledge to a broader number of professionals and may become an important tool for training in prevention and control of infections related to health care and in facing the challenges of antimicrobial resistance. The evaluation of the perception and attitude of professionals working in infection control committees on the program of infection control in their institutions highlighted important information that could be used by the Brazilian authorities to direct strategies to improve the programs of hospital infection control in each region of the country.
- ItemAcesso aberto (Open Access)Impacto de um programa de educação continuada na qualidade assistencial oferecida pela fisioterapia em terapia intensiva(Associação de Medicina Intensiva Brasileira - AMIB, 2014-03-01) Pinto, Walkyria Araújo Macedo; Rossetti, Heloisa Baccaro; Araújo, Abigail; Spósito Júnior, José Jonas; Salomão, Hellen; Mattos, Simone Siqueira; Rabelo, Melina Vieira; Machado, Flávia Ribeiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective:To evaluate the role of quality indicators and adverse events registering in the quality assessment of intensive care physiotherapy and to evaluate the impact of implementing protocolized care and professional training in the quality improvement process. Methods:A prospective before-after study was designed to assess 15 indicators of the quality of care. Baseline compliance and adverse events were collected before and after the implementation of treatment protocols and staff training. Results:Eighty-nine patients admitted, being 48 in the pre-intervention period and 41 in the post-intervention period with a total of 1246 and 1191 observations respectively. Among the indicators related to the global population, there was a significant improvement in chest x-ray control, multidisciplinary rounds and shift changes as well as in compliance with these decisions. Indicators related to the population under mechanical ventilation, obtained by direct observation at bedside, showed a significant improvement in the compliance with the tidal volume of 6-8mL/Kg, plateau pressure <30cmH2O, adequate mechanical ventilation alarm setting, mechanical ventilation humidification control, adequate humidification line exchange and orotracheal tube position. Among the mechanical ventilation indicators collected through the physiotherapy records, there was significantly improved compliance with the predicted tidal volume registry and cuff pressure registry. There was a significant reduction in the number of adverse events. There was no impact on intensive care unit mortality, length of stay, duration of mechanical ventilation and ventilator-free days.Conclusion:It is possible to measure the quality of physiotherapy care using indicators of quality control. The implementation of care protocols and training of the professionals can improve team performance.
- ItemAcesso aberto (Open Access)Implementação do Programa de Melhoria do Acesso e Qualidade segundo gestores da Atenção Básica de São Paulo(Univ Fed Sao Paulo, Dept Enfermagen, 2017) Coelho e Silva, Lais Marques [UNIFESP]; Ferreira, Lucilene Reno [UNIFESP]; Rosa, Anderson da Silva [UNIFESP]; Neves, Vanessa Ribeiro[UNIFESP]Objective: To analyze the implementation of the National Improved Access and Quality Program according to Primary Health Care managers. Methods: The thematic oral history was used, through semistructured interviews with five managers from Primary Health Care Services who participated actively in the two cycles of the Program in an administrative district of Sao Paulo City. The subjects answered the question "How do you assess the implementation process of the National Improved Access and Quality Program at this Primary Health Care Service?", among others. The analysis of the testimonies revealed the categories "The managers' perception of the implementation of the National Improved Access and Quality Program" and "Changes in the work processes since the implementation of the National Improved Access and Quality Program". Results: The managers acknowledged the Program as a well-structured proposal, which permits a broader management view on the health services. The interviewees evidenced the use of the quality indicators, which was hardly addressed and understood in the managers and teams' daily reality though. The interviewees demonstrated that they do not understand the concepts of continuing education and institutional support. The external evaluation phase was considered subjective and without standardization, producing data that did not contribute to the assessment of the changes the teams made. Conclusion: The systematic incorporation process of the assessment culture to support the continuing quality improvement in Primary Health Care is incipient. Despite the continuing distance between the proposals of Primary Health Care and the practice at the Primary Health Care services studied, the Program favored the organization of the work processes and contributed to the managers' focus on the teams' practice and their own activities.
- ItemSomente MetadadadosKnowledge and practice of physicians and nutritionists regarding the prevention of food allergy(Churchill Livingstone, 2013-08-01) Ribeiro, Camila Cury [UNIFESP]; Speridião, Patrícia da Graça Leite [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background & aims: To evaluate the knowledge and practice of pediatricians, pediatric gastroenterologists, allergists and nutritionists regarding the primary prevention of food allergy.Methods: A descriptive, cross-sectional study that enrolled pediatricians (n = 80), pediatric gastroenterologists (n = 120), allergists (n = 100) and nutritionists (n = 220). A self-administered questionnaire concerning the current recommendations was used.Results: Despite the lack of current recommendations, 17.1% (n = 89) of all professionals, mainly nutritionists, recommended a maternal exclusion diet during pregnancy. More professionals in the sample group, 40.8% (n = 212), recommended a maternal exclusion diet during breastfeeding, and the rates of recommendation were higher in nutritionists and pediatricians compared to allergists and pediatric gastroenterologists (p < 0.001). Regarding the recommended timing of the introduction of complementary feeding, 41.9% (n = 218) of the professionals recommended modifying the age of introduction to prevent the development of food allergy. the majority of the professionals believed that prebiotics (61.2%; n = 318) and probiotics (44.4%; 231) prevent the development of food allergy. the recommended age of introduction for the main allergenic foods was 12 months.Conclusions: This study revealed that there are gaps in the knowledge of professionals about the primary prevention of food allergy. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
- ItemAcesso aberto (Open Access)Processos de acreditação para o enfermeiro: um recorte histórico(Associação Brasileira de Enfermagem, 2009-02-01) Gentil, Rosana Chami [UNIFESP]; Sanna, Maria Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)To identify, describe and analyze the historical milestones of nurses' accreditation in the critical care area, a research was carried out at LILACS and MEDLINE, unearthing 16 publications, led to the 4 categories. In the USA, the CCNE and NLNAC focus on evaluating Nursing courses and educational institutions, whilst generalist nurses are evaluated by NCLEX, and experts are evaluated by professional associations. Accrediting nurses is also a matter of interest in Spain, Canada, South Africa and Australia. In the USA, the process began in the 40's, whilst in Spain it began in the 90's. It was concluded that the professional certification and accreditation in Nursing occur mainly in developed countries and began in the middle of the last century.